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March 27, 2018 by James Swisher

Lean and Six Sigma Are Transforming Healthcare

Maybe you’ve heard of Lean.  It’s the name we give the philosophies, tools, and systems originally developed by Toyota to build highly reliable and consistent cars.  Lean isn’t just for cars, though.  It’s been adopted by thousands of companies worldwide and is a proven catalyst for improving quality, reducing costs, and boosting employee morale.  It’s sister discipline, Six Sigma, developed at Motorola in the 1980s and popularized at General Electric in the 1990s, leverages statistical tools to understand and improve business processes.  Together, Lean and Six Sigma (typically called “Lean Six Sigma”) have proven to be a powerful driving force for improvement in healthcare.

In his book “Lean Hospitals,” author Mark Graban quotes a senior leader at a prestigious university hospital as lamenting, “we have world-class doctors, world-class treatment, and completely broken processes.”  That senior leader is not alone.  Hospital leaders across America struggle every day with operational challenges like adjusting staffing to varying volumes, finding equipment and supplies when needed, and even starting surgical cases on time.  Moreover, hospital administrators are challenged to improve both employee engagement and patient satisfaction in this very challenging environment.  Practically none of those challenges are caused by bad or uncaring people, though.  Instead, the root cause is almost always ineffective or wasteful processes that sap employee energy and deliver sub-par experiences for patients.  Lean Six Sigma can change that.

Lean is primarily focused on eliminating waste.  That is to say, it aims to get rid of things that take employee time and energy, but don’t add value to patients.  It offers not just tools to find and eliminate waste, but a philosophy that respects and empowers the people who care for patients.

Six Sigma is primarily focused on reducing variability.  That is to say, it aims to deliver consistent, repeatable, and reliable results within certain statistical limits.  It offers powerful statistical tools that get beyond simple graphs and intuition to quantify what kind of results processes are really capable of producing.

Together, Lean Six Sigma combines the insights of front-line staff members, the voice of the customer, and rigorous statistical analysis to deliver consistent patient experiences with efficient processes performed by engaged employees.  And that’s not just hyperbole.  ThedaCare in Appleton, Wisconsin and Virginia Mason in Seattle, Washington have been practicing Lean Six Sigma for more than a decade and can cite innumerable improvements.  For instance, Virginia Mason credits their Lean-based VPMS (Virginia Mason Production System) with increasing the amount of time nurses spend in direct patient care from 35% to 90%.  Hospitals across the country are adopting Lean Six Sigma and seeing results from reduced patient walk-outs in the Emergency Room to improved lab result turnaround times to shorter response times for patient transports with no additional staff required.

As simple as it may sound, one of the most powerful and important Lean concepts is: Respect for People.  Hawkeye Business Solutions was founded on a core belief in the power of people.  We take the time to listen to the people who do the work.  No one knows the real way your hospital runs better than your employees.  And while we’d like to say we have all the answers, the reality is your employees often already know how to fix many of your biggest problems.  They’re just not engaged enough to tell you.  At Hawkeye, we use a Lean Six Sigma process known as a Rapid Improvement Event (RIE) to reengage staff and develop solutions that unlock the power and creativity of your workforce.  We spend time in the “gemba,” the place where work is done, and involve those who do the work in designing, testing, and implementing solutions in a rapid, iterative learning environment.  You might be surprised; a day on the work floor might provide more fresh ideas than ten days in a conference room.

If you want to learn more about how Hawkeye Business Solutions uses Lean Six Sigma in its engagements, please contact us at 540.232.9920 or info@hawkeyebusinesssolutions.com.  We’re excited to help you discover the innovativeness of your employees and reach your organization’s potential.

Filed Under: Healthcare, Lean

October 7, 2016 by James Swisher

Achieving Excellence in Healthcare Using Baldrige

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Healthcare leaders have been hearing a lot about the Malcolm Baldrige National Quality Award over the last fifteen years, and for good reason.  Baldrige has become an increasingly common framework used by top performing hospitals, and has become one of the dominant industries represented in the national annual quality award competition administered by the U.S. Department of Commerce’s National Institute of Standards and Technology (NIST).  On May 16, NIST announced that 34 businesses across 5 business sectors are vying for the prestigious award in 2016.  Of those, a whopping 62% (21 of the 34) were healthcare organizations (16 of 26 applicants were in healthcare in 2015, also 62%).  Every year since 2002, there have been at least 10 healthcare applicants and at least one healthcare Baldrige Award winner.

Hospital leaders not currently using the Baldrige framework often worry that adopting Baldrige means jettisoning their current strategic plan, performance improvement methodology, and/or balanced scorecard.  In fact, none of these is the case.  Baldrige provides a framework within which to structure and align strategies, methodologies, and measurement, not a replacement for them.  The Baldrige criteria don’t specify how to operate your business; they encourage you to define and evaluate your business within an internationally-recognized and proven framework.  According to NIST, the Baldrige Excellence Framework “helps you evaluate performance, assess where improvements or innovation are most needed, and get results.”

The Baldrige framework is composed of seven parts within a 1,000-point structure:

  1. Leadership (120 points)
  2. Strategy (85 points)
  3. Customers (85 points)
  4. Measurement, Analysis, and Knowledge Management (90 points)
  5. Workforce (85 points)
  6. Operations (85 points)
  7. Results (450 points)

For healthcare leaders, the first thing to notice about the structure is its focus primarily on results and secondarily on leadership.  Today’s leaders know that in this fast-paced and ever-changing healthcare landscape, nothing is more important than achieving results.  Our communities and our stakeholders demand and deserve great healthcare outcomes.  Baldrige places nearly half of the framework’s focus on achieving and maintaining superior results.  And, of the six remaining framework areas, notice what plays the biggest role in achieving results: leadership.  Baldrige focuses on important leadership factors like vision, values, and mission; communication and organizational performance; governance; and legal and ethical behavior.

A common question among leaders new to Baldrige is: Is it really an accurate gauge of performance excellence?  The answer is overwhelming “yes.”  A 2011 Thomson Reuters study compared Baldrige hospitals (award winners and applicants receiving site visits) to 100 Top Hospitals award winners and found:

  • Baldrige award recipients are significantly more likely to win a 100 Top Hospitals national award.
  • Baldrige hospitals were significantly more likely to display a faster pace of performance improvement over a five-year period.
  • Baldrige hospitals were 83% more likely to win a 100 Top Hospitals national award for excellence in balanced organization-wide performance.
  • Baldrige hospitals outperformed non-Baldrige hospitals in practically all individual performance measures used in the 100 Top Hospitals composite score.

Finally, healthcare leaders are often concerned that Baldrige won’t fit with other performance improvement initiatives like achieving Magnet status, maintaining accreditation with The Joint Commission, or participating in Institute for Healthcare Improvement (IHI) initiatives.  The good news is that Baldrige’s non-prescriptive approach is 100% compatible and congruent with these approaches.  The Baldrige framework allows leaders to organize and integrate multiple approaches to improve patient outcomes and achieve and sustain performance excellence.

If your organization is looking for a proven way to guide operations, improve performance, and achieve sustainable results, consider integrating the Baldrige framework into your organization’s DNA.  According to Eric Fletcher, Senior Vice President of Strategy, Marketing, and Business Development for Mary Washington Healthcare and an Alumni Baldrige Examiner, “One of the undersold benefits of the use of the Baldrige framework is its impact on organizational alignment and integration.  Devoted use of the framework leads to the tearing down of silos, and a true harmony among the processes and systems which propel an organization forward.  It’s not an easy journey, but world-class results await those who successfully implement the framework.”

If you need a little help starting your Baldrige journey, try beginning with some of the great (and free) resources offered by NIST at www.nist.gov/baldrige.  In particular, if you’d like to learn more about the criteria and how it improves organizational performance, a great place to start is Baldrige 20/20: An Executive’s Guide to the Criteria for Performance Excellence (available for free download at http://www.nist.gov/baldrige/publications/baldrige_20_20.cfm).  If you think you’re ready to take a crack at assessing where your organization stands today using a simplified version of the Baldrige framework, try the quick and easy Are We Making Progress? tool (available for free download at http://www.nist.gov/baldrige/publications/progress.cfm).  And, when you’re ready to progress in your performance excellence journey and don’t want to go it alone, contact Hawkeye Business Solutions at 540.232.9920 or info@hawkeyebusinesssolutions.com and we’ll help you jump-start your efforts.

Filed Under: Healthcare, Organizational Excellence

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  • Lean and Six Sigma Are Transforming Healthcare
  • Achieving Excellence in Healthcare Using Baldrige
  • Why Everyone Else’s Grade Matters As Much As Yours
  • Unlock Solutions Through Respect for People
  • Means to An End: Keeping Your Mission in Sight

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